I work acute GeroPsych.
RN does the meds (0800, 1400, 1700, 2000) (which usually takes about an hour with 10 pts) does a shift assessment on each patient and a shift note detailing their behaviors over the last 8 hours.
RN also does admission/discharges, and we don't have a HUC, so we do ALL the admission/discharge proceedings.
RN is responsible for assessing patients medically and updating the MD board once a shift with medical issues that need to be addressed.
The AM nurse does rounds with the Psychiatrist and Medical doctors.
PM nurses spend a lot of time doing behavioral interventions because everyone is sundowning.
NOC nurse does a lot of the administrative stuff- chart checks, QA checks on charting, tidying up the Dear Doctor notes and Staff Alerts and Family Update sections of the chart.
We have MHTs (Mental Health Technicians) that are responsible for 15 minute checks around the clock, toileting, turning, repositioning, supervising and interacting with the patients. We have an activities coordinator that comes M-F 9-5 and does groups with the patients.
This is how it's supposed to go- but it never does
The RN spends a lot more time on the floor than the list above indicates, because there's always someone who needs behavioral interventions, a PRN medication, a fluid flush, a catheter (inserted or changed), stool or emesis to be examined, or the MHTs need an extra person to help lift or transfer, or to be in the dayroom to supervise while they do a hoyer lift.... Plus families call A LOT wanting updates, and other facilities call at all hours looking for placement for their problem people...
Almost exclusively (99.99%) the admitting diagnosis is Dementia with Behaviors.
Most common etiologies for the Dementia with Behaviors are: Alzheimer's, Parkinson's, and Delirium NOS.
Rarer etiologies for the Dementia with Behaviors are: Bi-polar disorder, Schizo-affective disorder, Schizophrenia, Lewey Body and Korsakoff's Syndrome. (And a few "been bat-crap crazy their whole life and nobody knows quite why" patients.)
The RN is the Charge Nurse AND Worker Bee. We occasionally are fortunate to have 2 RNs on, but usually only on days where we are getting 2 admissions OR if we have a group of especially aggressive or mobile (or both) patients that need more 1:1 supervision.
I don't know if the specialty is competitive in general, but it's definitely not on my unit. We have quite a high rate of RN turnover (but a rather good retention rate for MHTs!) and we always have at least 1 job opening, especially for PM shift (which is probably the most difficult, as the behaviors tend to spike the most in the evenings.)